(07-30-2015 04:42 PM)Tom in Lazybrook Wrote: Dont complain when you get socialized medicine
This makes no sense, Tom. We're already complaining because the rules have been set up to eliminate free market solutions (by mandating non-economic policies) so that the government is the only solution... which is essentially socialized medicine. If we're already complaining about it, why wouldn't we do so even more when it becomes the norm? The options for the government are to spend more to make free market solutions economic... or to spend more to cover the same losses themselves. The difference is, you can incentivize private enterprise to be efficient, but it is virtually impossible to incentivize government to be so.... oh, and that if the government spends the money, politicians can extract power and value from the spending and they can 'hide' the actual costs in some omnibus bills. If they merely support private enterprise, they have less power and control over the actual dollars. Not a lot less... but less. They need business to be complicit with them in the former. In the latter, all they need is for other Congressmen to be complicit with them.
You guys act as if single-payer somehow makes things cost less. While it may make things cost less FOR YOU, it doesn't make them cost any less to deliver... and arguably makes them cost more. The government could easily make them cost less FOR YOU while also making them cost less to deliver by working WITH the private sector... but that obviously isn't the plan.
Because in case you didn't know... (and I know you did)... the wealthy in this country don't really care what you do. They can always just hire their own personal doctors... even leaving the country if they must. That's what Canadians do. The only question is whether Democrats are favoring the wealthy by this plan of action, or merely the 'well off'.
(07-30-2015 04:46 PM)Redwingtom Wrote: HB, don't blame us for not believing or being cynical every time we hear about the evil ACA without seeing the concrete proof.
The blatant lies and distortions the opponents have been telling for years and years...the countless stories that were continually debunked when looked into...the bogus kill grandma claims...the job killing lies...and on and on.
It's the same thing with Obama. The haters refused to stick to the issues and actual problems and went after everything under the sun from pastors, to birth certificates, to SSN's, to religion, to birth places, to book authors, to racism, to patriotism, to his wife, to her patriotism...I could go on for days.
Yet you haven't seen me do this. You've seen me repeatedly give you hard and fast data and reports from groups like KFF and the California board of Health and professors at 'liberal leaning' Universities... plus I've given you insight into the business models of the people delivering this care to you... not politicians.
I'd also point out that plenty of people are doing the same thing, just for the other team.... and you seem to believe every word they say, even when they too are debunked.
You have chosen a team, just like they have. Your methods and opinions are no more professional nor noble and often no better informed than theirs are.
Them being 'wrong' doesn't make you right. The job killing lies are no more pertinent than the job creation lies. All you're really doing is arguing that if you can prove their anecdotes not universal, that you don't have to believe their theme. The real question is whether their theme is correct or not, and not whether or not they know enough to be able to prove it to you.
You have decided that I am wrong about the ACA because I have the same 'general' opinion as some who simply don't like the ACA because they don't like Obama.... I think my signature applies to you.
(07-30-2015 05:40 PM)Tom in Lazybrook Wrote: Been on the phone with them for over an hour now. They're still trying to figure out where current PPO customers will go in 2016 for cancer treatment in Houston when they get switched to the HMO. This is effectively cancelling Cancer treatment as a covered item. I'll ask about Heart disease tomorrow. They're going to get real sick of me.
And its not Obamacare that's driving this...its Texas' refusal to work with Obamacare to take the millions in extra Medicare dollars that are used to fund care.
If you don't have cancer or heart disease and you aren't an investigative reporter or otherwise a public advocate such that you could ask the question once and spread the answers to tens of thousands who need to know... I wish you wouldn't waste their time (and our money) when they could be better served either solving the issue or telling those who CAN spread the word rather than those who can't/don't. If you do, then fine... but I don't want to encourage others to do so.
This is a perfect example of someone spreading misinformation though.... saying things that sound right if that is what you already believe... but when you look at it, you realize that these issues aren't inter-related at all.
The extra dollars Texas has refused are medicaid dollars, not medicare dollars... Since Medicare is managed by the feds and medicaid by the states, there IS no way Texas could 'turn down' Medicare dollars... since they don't have any say in it whatsoever.... and they would 'arguably' provide care to currently uninsured poor people, not people with a PPO.... and both Medicare and Medicaid generally reimburse more than the exchange plans, which is precisely the problem with the individual market we are discussing. I'm not going to argue about whether or not Texas should expand medicaid or not.... because while I'm convinced I know more than most about it, NONE of us can know enough to answer that question decisively. There are legitimate reasons why a state shouldn't expand medicaid. That is a statement of fact. The money is not without strings or consequences. Whether or not Texas' reasons are legitimate is a matter of debate, not fact. Texas also didn't decide what the premiums or subsidy or reimbursement levels should be for the Federally mandated plans. Very few people (probably close to 0%) in that window between 100% of the FPL and 133% of the FPL, much less in the 0-100% of the FPL would be buying PPOs anyway, even if the were given the choice. They are virtually by definition more expensive than an HMO because they offer broader access. If you don't have any income and your choices are a fully paid HMO with no copays and a $1,000 OOP max or a fully paid PPO with $50 copays and a $3,000 OOP max, which are you going to choose? Again, not saying it's absolutely zero, but I suspect it's within a rounding error of it.
Here you go, Redwingtom...
I hope I don't need to provide links that show the differences between medicare and medicaid... or that HMOs are generally cheaper than PPOs. I've already shown you links to left-leaning groups that talk about mandated lower reimbursements from these insurance plans... and the rest just seems like common sense/business to me.
For all of you so excited about single payer... let me clue you in a bit.... simplifying as much as possible...
What an HMO does is pay everyone who MIGHT be involved in your care a set fee each year, whether or not they actually deliver any care to you. What does that incentivize? What I see in my profession is that it incentivizes doctors to deliver less care... the minimum their contract allows... to make you wait to see them to make 'sure' you need them... and if possible, to quickly 'dump' your care to home, family or another provider if they can.It also encourages them to seek out generally healthier populations, but that is less controllable. .. which is why you must stay in the network and why you need referrals. If the contract says you're supposed to see an average of 15 patients a day, almost none will see substantially more than that. There is NO fee for service and no incentive to do more than is required. They COULD simply work harder and deliver you the care... or they could simply expect the government to EVENTUALLY add more doctors to the plan to deliver your care. I laugh when I hear politicians talk about decisions should be between a doctor and their patient, and then they insert themselves squarely into that mix like this. In a PPO, this is also the general rule for people 'in the network'... however there is a 'slight' augmentation for actually delivering the care, and then a bundle of money to cover out of network services on what is essentially a fee for service basis. It's like a 70/30 'fixed' as opposed to the almost 100% of an HMO.
An hmo is great if you don't care who is seeing you or whether they care about seeing you... not saying none of them care about you or that they only care about the money... they probably wouldn't be doctors, especially PCPs if that were the case... but it's human nature. Especially when you add the flexibility to go out of network which is especially important in rural areas or for specialists or when you travel or go to school out of the area... I just don't see how we can really even remotely argue that we are 'better off' if those go away. Sure, lots of people are fine without them... but for many others, it will suck... HARD.
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Obamacare already collapsing in Texas
